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Relationship Between Education and Dementia: An Updated Systematic Review

Sharp, Emily Schoenhofen MA; Gatz, Margaret PhD

Alzheimer Disease & Associated Disorders: October-December 2011 - Volume 25 - Issue 4 - p 289–304
doi: 10.1097/WAD.0b013e318211c83c
Review Article

Objective The purpose of this study was to review the relationship between education and dementia.

Methods A systematic literature review was conducted of all published studies examining the relationship between education and dementia listed in the PubMed and PsycINFO databases from January 1985 to July 2010. The inclusion criteria were a measure of education and a dementia diagnosis by a standardized diagnostic procedure. Alzheimer disease and Total Dementia were the outcomes.

Results A total of 88 study populations from 71 studies met inclusion criteria. Overall, 51 studies (58%) reported significant effects of lower education on risk for dementia, whereas 37 studies (42%) reported no significant relationship. A relationship between education and risk for dementia was more consistent in developed regions compared with developing regions. Age, sex, race/ethnicity, and geographical region moderated the relationship.

Conclusions Lower education was associated with a greater risk for dementia in many but not all studies. The level of education associated with risk for dementia varied by study population and more years of education did not uniformly attenuate the risk for dementia. It seemed that a more consistent relationship with dementia occurred when years of education reflected cognitive capacity, suggesting that the effect of education on risk for dementia may be best evaluated within the context of a lifespan developmental model.

Department of Psychology, University of Southern California, Los Angeles, CA

Supported in part by a grant from the National Institute on Aging: Multidisciplinary Research Training in Gerontology (5T32AG00037, Principal Investigator: Eileen Crimmins, PhD).

The authors declare no conflicts of interest.

Reprints: Emily Schoenhofen Sharp, MA, Department of Psychology, University of Southern California, 3620 McClintock Avenue, Los Angeles, CA 90089-1061 (e-mail:

Received July 11, 2010

Accepted January 5, 2011

© 2011 Lippincott Williams & Wilkins, Inc.